Abstract

Outcome measurement in pediatric palliative care (PPC) is receiving increasing attention. The FACETS-OF-PPC, a multidimensional outcome measure for children with severe neurological impairment, has been developed and partly validated. This study aimed to conclude the validity of the German version of the FACETS-OF-PPC. A multicenter prospective study with two points of measurement has been conducted, employing confirmatory factor analyses, reliability analyses, and analyses to evaluate the tool’s sensitivity to change. Overall, 25 inpatient and outpatient teams throughout Germany recruited N = 227 parents of affected children and N = 238 professional caregivers. Participants filled out the FACETS-OF-PPC on the admission of a child to a palliative care service and at discharge from inpatient settings or two months after admission to outpatient services. The analyses revealed the questionnaire needing further adaption. Now, 17 of the original 34 items contribute to the construction of the questionnaire scales. The other items remain part of the questionnaire and may be evaluated descriptively. Furthermore, the FACETS-OF-PPC has moderate to appropriate internal consistency and is sensitive to change. Creating an outcome measure with good psychometric properties for the vulnerable population of children with severe neurological impairment appears extremely difficult. Considering these challenges, the FACETS-OF-PPC demonstrates adequate psychometric properties.

Highlights

  • Outcome measures in pediatric palliative care (PPC) should be multidimensional in order to capture its holistic nature, including physical, psychological, social, and spiritual aspects [1]

  • No research on multidimensional outcome measurement focusing on pediatric palliative care patients with congenital and neurological conditions has been conducted

  • Even though these children constitute the largest patient group within pediatric palliative care in children under the age of 16 years [2], studies on multidimensional outcome measurement in this field have so far mainly focused on children with cancer [3,4]

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Summary

Introduction

Outcome measures in pediatric palliative care (PPC) should be multidimensional in order to capture its holistic nature, including physical, psychological, social, and spiritual aspects [1]. No research on multidimensional outcome measurement focusing on pediatric palliative care patients with congenital and neurological conditions has been conducted. Recent research suggests that assuming the adequacy of outcome measures developed for pediatric cancer patients would be highly inappropriate for use in children with congenital and neurological conditions, emphasizing the need for targeted research [5]. A study by Pelke et al [8] has developed a specific multidimensional outcome tool for children with congenital and neurological disorders who are affected by severe neurological impairment and their families. It is called the Family-Centered Multidimensional Outcome Measure for Pediatric Palliative Care, the FACETS-OF-PPC in short. Certain steps are still missing in order to further substantiate the assessment of the tool and its adequacy as an outcome measure

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